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Many experts predict that genetic testing for disease susceptibility is well on its way to becoming a routine part of clinical care. Yet many of the genetic tests currently being developed are, in the words of the World Health Organization (WHO), of “questionable prognostic value.
—Leslie Pray, PhD
Obesity remains one of the most common chronic diseases in the United States. As a leading cause of United States mortality, morbidity, disability, healthcare utilization and healthcare costs, the high prevalence of obesity continues to strain the United States healthcare system (Obesity Society, 2016).?
More than one-third (39.8%) of U.S. adults have obesity (CDC, 2018). The estimated annual medical cost of obesity in the U.S. was $147 billion in 2008 U.S. dollars; the medical costs for people who are obese were $1,429 higher than those of normal weight (CDC, 2018).
According to the Centers for Disease Control and Prevention (CDC), the rate of childhood obesity has tripled in the past 30 years, with an estimated 13.7 million children and adolescents considered obese (CDC, 2018). When seeking insights about a patient’s overall health and nutritional state, body measurements can provide a valuable perspective. This is particularly important with pediatric patients.
Measurements such as height and weight can provide clues to potential health problems and help predict how children will respond to illness. Nurses need to be proficient at using assessment tools, such as the Body Mass Index (BMI) and growth charts, in order to assess nutrition-related health risks and pediatric development while being sensitive to other factors that may affect these measures. Body Mass Index is also used as a predictor for measurement of adult weight and health.
Assessments are constantly being conducted on patients, but they may not provide useful information. In order to ensure that health assessments provide relevant data, nurses should familiarize themselves with test-specific factors that may affect the validity, reliability, and value of these tools.
This week, you will explore various assessment tools and diagnostic tests that are used to gather information about patients’ conditions. You will examine the validity and reliability of these tests and tools. You will also examine assessment techniques, health risks and concerns, and recommendations for care related to patient growth, weight, and nutrition.
Students will:
When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to accurately interpret the results.
Not only do these diagnostic tests affect adults, body measurements can provide a general picture of whether a child is receiving adequate nutrition or is at risk for health issues. These data, however, are just one aspect to be considered. Lifestyle, family history, and culture—among other factors—are also relevant. That said, gathering and communicating this information can be a delicate process.
For this Assignment, you will consider examples of children with various weight issues. You will explore how you could effectively gather information and encourage parents and caregivers to be proactive about their children’s health and weight.
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
Assignment (3–4 pages, not including title and reference pages):
Assignment: Child Health Case:
Include the following:
Case 1: Acklin, Alvarez, Amama, Basco, Black, Bolivard, Brown & Colyer
4-year-old overweight female with normal weight parents who are living with elderly grandparents in their home
Case 2: Curry, Fobanjong, Garcia, Green, Hutcheson, Iskander, Jean & Johnson
10-year-old severely underweight male in 3rd grade who lives with her normal weight mom on the weekends and her underweight father during the week.
Case 3: Jordan, Moore, Parfait, Pina, Queija, Raymond & Russell
5-year-old severely underweight male who lives with his normal weight adopted mother and father.
o Chapter 3, “Examination Techniques and Equipment”
This chapter explains the physical examination techniques of inspection, palpation, percussion, and auscultation. This chapter also explores special issues and equipment relevant to the physical exam process.
o Chapter 8, “Growth and Nutrition”
In this chapter, the authors explain examinations for growth, gestational age, and pubertal development. The authors also differentiate growth among the organ systems.
o Chapter 1, “Clinical Reasoning, Evidence-Based Practice, and Symptom Analysis”
This chapter introduces the diagnostic process, which includes performing an analysis of the symptoms and then formulating and testing a hypothesis. The authors discuss how becoming an expert clinician takes time and practice in developing clinical judgment.
o Chapter 2, “The Comprehensive History and Physical Exam” (Previously read in Week 1)
o Chapter 5, “Pediatric Preventative Care Visits” (pp. 91 101)
Use the following resources to guide you through your Shadow Health orientation as well as other support resources:
Taking a Health History
How do nurses gather information and assess a patient’s health? Consider the importance of conducting an in-depth health assessment interview and the strategies you might use as you watch. (16m)
o Chapter 3, “The Screening Physical Examination”
o Chapter 17, “Principles of Diagnostic Testing”
o Chapter 18, “Common Laboratory Tests”
Nutrition, among other things, influences children’s growth and development. The nutritional need is especially important before a child reaches the age of five, owing to the robust physical and physiological development. At this stage of development, any dietary deficiency has both short- and long-term health repercussions. The case study is about a five-year-old severely underweight child who lives with his normal-weight adopted mother and father. His weight predisposes him to several health issues and hazards, as detailed below.
Given the consequences of malnutrition, especially during the first five years of life, adequate nutrition is paramount. Low weight for age is one of the signs of malnutrition, as demonstrated in the 5-year-old child’s case scenario. Concerning health issues and risks, the child will undergo immunological, cardiovascular, gastrointestinal, endocrine, genitourinary, and circulatory changes.
The immune system of malnourished children is significantly compromised due to decreased immunoglobin levels, reduced complement system, and low phagocytic activity, putting the child at risk of infections (Dipasquale et al., 2020). In the cardiovascular system, the patient is in danger of diminished cardiac output and low blood pressure, which may lead to hypoperfusion of the body’s vital organs (Dipasquale et al., 2020).
Because of the gut’s diminished absorptive capacity, nutritional absorption is substantially reduced, exacerbating undernutrition. Furthermore, in the genitourinary system, the kidney’s capacity to excrete excess acid and water is severely diminished, and the patient is vulnerable to urinary tract infections due to inadequate immunity (Dipasquale et al., 2020). The many biochemical and physiological changes are a response to the body’s already low energy levels.
Obtaining a medical history from children may be challenging; consequently, in most circumstances, proxy reporting by parents is helpful. It is critical to gather information on the various causes of the child’s malnutrition, as well as vital data for the child’s diagnosis.
Data on the child’s dietary intake may tell if child abuse is a likely cause of malnutrition. According to Burford et al. (2020), the underprivileged, such as adopted children, may encounter medical neglect in a variety of ways, one of which is a deprivation of adequate nutritious food. Asking the parents about the child’s dietary schedule, components, and capacity to acquire food is vital
Malnutrition may be caused by nutritional deprivation, but it can also be associated with other medical conditions. I would have to determine whether the child has any medical condition that causes significant wasting, such as HIV, tuberculosis, malignancies, or any other chronic disease. Laboratory testing would also provide further information to aid in determining the cause of malnutrition.
Among the valuable laboratory data that would be required are a complete blood count or blood culture, which may indicate an infection as a cause or a consequence of malnutrition, HIV testing, and Xpert MTB/RIF for tuberculosis (Keller, 2019). Because the child is adopted, obtaining information from the parents may be challenging because they are more likely to conceal any history of the child’s mistreatment.
As a result, emphasizing the significance of the medical history to the parents, explaining to them in clear, precise, and unadorned language, and acknowledging or speaking to them in their local language are critical in acquiring the information.
Burford, A., Alexander, R., & Lilly, C. (2020). Malnutrition and medical neglect. Journal of Child & Adolescent Trauma, 13(3), 305–316. https://doi.org/10.1007/s40653-019-00282-0
Dipasquale, V., Cucinotta, U., & Romano, C. (2020). Acute malnutrition in children: Pathophysiology, clinical effects and treatment. Nutrients, 12(8), 2413. https://doi.org/10.3390/nu12082413
Keller, U. (2019). Nutritional laboratory markers in malnutrition. Journal of Clinical Medicine, 8(6), 775. https://doi.org/10.3390/jcm8060775
Malnutrition in children is a weight and nutrition-related condition that has caused a significant morbidity and mortality both in the developing and developed countries. Underweight condition is defined by the body mass index (BMI) or body fat percentage that is too low for general sustainable health. According to the World Health Organization, weight is charted against the age of the child. The child is then considered underweight when their weight for age falls below negative two standard deviations (WHO, 2010).
Severe underweight in children is associated with nutritional and immunity deficiencies that place the individuals at risks of growth impairment presenting with stunting, osteoporosis, and recurrent infections. The body requires minerals and nutrients for growth, sustenance and immune system development.
Underweight individuals are also at risks of developing cardiovascular diseases. However, their risk of developing cardiovascular disease is less than that of the obese and overweight individuals (Park et al., 2017). In comparison, the risk in overweight individuals depends on coexisting comorbidities while that in underweight individual does not.
Being underweight has been recently associated with higher mortality than normal. The impact is worse in older populations than younger age groups (Lorem et al., 2017). Underweight individuals are also at risk of developing acute recurrent infections. Common infections include the upper respiratory tract infections (URTIs) and skin infections (Harpsøe et al., 2016). For this reason, comprehensive interventions are necessary to mitigate the effects of being underweight on long-term health outcomes.
The patient for this week’s case study is a twelve-year old Hispanic girl who is severely underweight. Her parents are underweight as well. She recently experienced bullying in school, probably due to her condition. Weight below the normal for age can be acute or chronic depending on the duration and onset of decline in weight.
Additional information required to assess her health would further include the family nutrition, health conditions during the pregnancy, birth, and postnatal life (Kumar et al., 2019); and presence of chronic familial illnesses (Tatsumi et al., 2016). The information acquired would determine the type of under-nutrition and the most appropriate management approach.
Since the girl’s parents are also underweight, it would be prudent to examine the history of genetic or familial chronic illnesses in the nuclear and extended families. The circumstances during pregnancy that are worth examining include the maternal nutritional knowledge level. The mother’s nutrition during the prenatal period and nutrition of the child in the postnatal life would be responsible for the weight status of the patient.
Information about sugar control and diabetes in the family is also important in assessing the weight status of the child. Type I diabetes, common in childhood, sometimes has a genetic component. Diabetes presents with weight loss that could be responsible for the child’s underweight status (Balcha et al., 2018). Other chronic illnesses too inhibit proper growth and weight increase.
The etio-pathogenesis of underweight status and malnutrition in not limited to nutritional causes. Therefore, specific questions will be necessary to gather more information to make more accurate diagnosis and build a more accurate health history. I would ask the child’s informant the following specific questions:
These three questions would assess the nutritional status of the family, inherited conditions, and the severity or developmental consequences of the low weight for age.
Barriers in health promotion for weight and nutritional management exist between healthcare providers and the caretakers or the parents of children. The fulltime caregivers for the child are the parents and therefore, I would enhance patient education and health maintenance through collaboration with the parents. The two strategies that I would use include proper and effective communication and nutritional recommendations.
Further, I would need to fully understand the cultural origin and eating patterns of the patient’s family. This will be achieved through nutritional assessment before applying the recommendations and strategies. Often, social stigma arises due to low weights and malnutrition among families. Sometimes parents are not willing to discuss these with their care providers. They end up holding vital information that would help the clinician to solve the nutritional issues in a cheaper and more efficient ways (Dev et al., 2017).
I would ensure open and free communication to discuss with the parents about their knowledge of under-nutrition and low weight for age, as well as the risks associated with child under-nutrition. At this time, the actual etiologies of under-nutrition for the patient are unknown and this discussion would provide the possible etiologies and therapies. I would reassure the parents on their abilities and role in maintaining an adequate weight and health for their child and that their child’s low weight may not primarily be the result of their parenting skills.
Finally, the nutritional strategy would include advising the parents on their role on the child’s food intake and lifestyle. I would encourage the parents to give the child more meals in small quantities in a day. Increasing the frequency and reducing the amount of food intake allows the body to maximize the calories intake and absorption.
I would also encourage adequate sleep and increase in playing time for the child to promote cardiovascular function (Centers for Disease Control and Prevention, n.d.). The parents would also be advised to provide adequate amounts of water to their child after meals and limit too much fatty foods as it would not be healthy for the child’s cardiovascular system.
Assessment Tool Worksheet Assignment Paper
Details: For this assignment, complete the “Assessment Tool Worksheet.” Use the worksheet to list the appropriate assessment tool(s) you would use for the provided client situation and population.Assessment Tool Worksheet Assignment Paper
While APA style is not required for the body of this assessment, solid academic writing is expected and in-text citations and reference Students should use the Academic Writing Resource located in the course materials folder.
SOC-449 Assessment Tool Worksheet
For this assignment, list the appropriate assessment tool(s) you would use for the provided client situation and population. Provide your reasoning for the assessment tool you listed citing two to four sources to support your reasoning:
Turn in the completed assignment by the end of Topic 5.
Client Situation and PopulationAssessment ToolValerie from “Getting Back to Shakopee” video (Topic 1 folder in MindTap) Native American woman struggles with low self-esteem and alcoholism.Tool:Reasoning:
Marta Ramirez case study (in Chapter 1 of the textbook)–Hispanic lower socioeconomic status woman.Tool:Reasoning:
Carl video (Topic 7 folder in MindTap)- Middle-aged heroin addictTool:Reasoning:
Greg video (Topic 3 folder in MindTap)- Young adult arrested for DUI.Tool:Reasoning:
Rosetta video (Topic 5 folder in MindTap)-Middle-aged African American female with young adult lesbian daughter.Tool:Reasoning:
SOC 449 Week 7 Treatment and Intervention Plan-GCU
Details:
View the “Carl Case Study”, “Lillian Case Study”, and the “Keeping Confidence: Suicide” videos located in the Topic 7 folder in MindTap. Select one to use for this assignment. Be sure to take notes on the intake information presented at the beginning of the case in the selected video. Assessment Tool Worksheet Assignment Paper
After you have viewed all three videos, select one to create a possible treatment plan (500-750 words) for the case study that includes only the following sections:
A social phenomenon can be defined as behavior that influences or is influenced by a client. When dealing with a client it is important to understand their behavior and why they are behaving like that. In this essay, the social phenomenons apparent in the video, “Home for the Holidays” will be explained. As well as theories a social worker needs to be familiar with in order to help a client in their situation Assessment Tool Worksheet Assignment Paper.
This essay will also include the ways a social worker can use the theories to help the client work through their social phenomena and identify the appropriate principles that align with ethical practice in the video “Home for the Holidays”.
Social Phenomenons that were apparent and presented to the social worker, in this case, were the couple trying to figure out where they should spend the holidays at. Ana doesn’t feel comfortable at Jackie’s house because she feels Jackie’s family isn’t as welcome of the fact they are gay.
Ana asks why should she have to compromise herself for Jackie’s family. Jackie’s behavior towards going home is a little selfish because she doesn’t want her family to kick her out because she is gay. However, Ana is trying to explain to Jackie that if she talks to her family about being gay they are more likely to be more open to the idea of them as a couple.
A social worker should be familiar with the psychosocial theory, systems theory, Pargament’s theory of religious coping, and lastly be comfortable with the ecological systems model. The psychosocial theory, “focuses on the ways that individuals are shaped by and react to their social environment” (Campbellsville, 2019). Assessment Tool Worksheet Assignment Paper
This theory can help the client work through their social phenomenas by showing them the social environment is having a negative or positive effect on their behavior and how they are being shaped. An example from the video can be when Jackie is talking about the environment she grew up in and Ana points out how she is so much like her family. She is like her family because she grew up surrounded by them.
Systems theory, “states that behavior is influenced by a variety of factors that work together as a system” (Campbellsville, 2019). This theory can be used by the social worker to figure out the factors that are working together to influence the client’s behavior. Pargament’s theory of religious coping may be another theory a social worker should be familiar with as it might help people who are dealing with tough issues find their answers in religion.
This theory has five major functions, “to discover meaning, to garner control, to acquire comfort by virtue of closeness to God, to achieve closeness with others and to transform life” (Xi, 2016). Lastly, it may be helpful for a social worker to understand a client’s ecological systems model.
This model makes, “a close conceptual fit with the “person-in-environment” perspective that dominated social work…” (Hepworth, Rooney, Rooney, & Strom-Godfried, 2016). By using the ecological systems model the social worker will be able to understand the client’s background and their surrounding environment. Assessment Tool Worksheet Assignment Paper
The NASW Code of Ethics, “is intended to serve as a guide to the everyday professional conduct of social workers” (NASW, 2020). There are six values in the NASW Code of Ethics which include, service, social justice, dignity and worth of a person, importance of human relationship, integrity and, competence. In this video “Home for the Holidays”, the principles that align with ethical practice in this case study include service, social justice, the importance of human relationship, and integrity.
The first service is important in this case because a social worker’s primary goal is to help people in need and address any social problems they are dealing with. Next social justice is important in this case because the couple is part of a discriminated group.
This case also aligns with the principle of the importance of human relationships. The couple was sacrificing their relationship for other relationships, causing a weak relationship between Ana and Jackie. Assessment Tool Worksheet Assignment Paper
The social worker was able to see that and thought of ways to help make their relationship stronger. Lastly, integrity, the social worker behaved in a trustworthy manner and communicated openly to the clients about what would and wouldn’t be shared.
Social workers need to be able to identify how social contractions influence a client’s life. Each client will have different ways of expressing social phenomenas happening in their life and it is important to understand their behavior and why they are behaving like that.
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Assignment Clarifying Research
Assignment 11: Barriers to Nurses’ Participation
Week 1 Discussion Prompt 1 Attachment
Total views: 26 (Your views: 2)
Be sure to include the rationale for your position in your discussion.
Due Sunday
Click here to submit your public policy meeting approval.
Create a thread seeking approval for your public policy meeting. Choose a meeting to view or attend. It must be a public policy body at work and related to health care. If it is a recorded meeting, please ensure it has been posted within the last year.
Click on this forum, then click ‘Create New Thread.’ Title the thread with your name and the name of the policy meeting. For example, Janice Smith: Affordable Health Care Policy Meeting
In the body of the thread, include:
https://www.c-span.org/ (search the video library or the live sessions)
http://www.youtube.com (perform a search for your topic)
Your local government or healthcare organization websites
If another student has already posted your policy meeting or subject, please choose another meeting.
You do not have to respond to peers in this prompt, but you may do so.
Due WednesdayAssignment 11: Barriers to nurses’ participation
Discussion 2 Attachment
Total views: 22 (Your views: 1)
Discussion 1 Attachment
Collapse
Total views: 29 (Your views: 1)
Reflect upon the survey you took. In your initial response, address some of the following questions. Explain your answers.
You need to log in and watch the video
Adhere to APA formatting and cite all sources. Review the rubric for further information on how your assignment will be graded.
Due: Sunday, 11:59 p.m. (Pacific time)
Points: 40
Watch the following three videos and choose one to address for your assignment.
Prior to beginning work on this assignment, read the Ryder, Ban, & Chentsova-Dutton (2011) “Towards a Cultural-Clinical Psychology,” American Psychological Association (2014) “Guidelines for Prevention in Psychology,” Hage, et al. (2007) “Walking the Talk: Implementing the Prevention Guidelines and Transforming the Profession of Psychology,” and Rivera-Mosquera, et al. (2007) “Prevention Activities in Professional Psychology: A Reaction to the Prevention Guidelines” articles.
Clinical and counseling psychology is a dynamic field that is constantly evolving and striving toward better treatment options and modalities. In this literature review, you will explore and integrate psychological research into a literature review, addressing current trends in three major areas of clinical and counseling psychology: assessment, clinical work, and prevention.
In your review, include the following headings, and address the required content.
Support this section with information from the Ryder et al. (2011) article “Towards a Cultural-Clinical Psychology” and at least one additional peer-reviewed article from the University of Arizona Global Campus Library.
Support this section using a minimum of three peer-reviewed articles from the University of Arizona Global Campus Library. The recommended articles for this week may be useful in generating your response.
Review the “Guidelines for Prevention in Psychology” (American Psychological Association, 2014), and support this section with information from the Hage, et al. (2007) “Walking the Talk: Implementing the Prevention Guidelines and Transforming the Profession of Psychology,” and Rivera-Mosquera, et al. (2007) “Prevention Activities in Professional Psychology: A Reaction to the Prevention Guidelines” articles.
Must be 7 to 10 double-spaced pages in length (not including title and references pages) and formatted according to APA style as outlined in the Writing Center (Links to an external site.).
Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.
Communication is so very important. There are multiple ways to communicate with me:
For this 4-5 pages assignment, you will conduct a focused health history and physical assessment based upon your Practice Experience work in Shadow Health. Particularly, you will complete a focused assessment on Esther, an elderly patient who is complaining of abdominal discomfort. Please submit your summary documentation in MS Word. Use the submission parameters and rubric below to guide you in completion of this written assignment.
For this written assignment, please use the following guidelines and criteria. Also, please refer to the rubric for point allocation and assignment expectations. The expected length of the paper is approximately 4-5 pages, which does not include the cover page and reference page(s).
Describe the focus of this particular assessment on the patient complaining of abdominal discomfort.
Describe the ROS, PMH, and other relevant data in this section.
Describe the physical examination findings including techniques of examination. Documented evidence to support clinical reasoning. Describe the list of differential diagnoses
Describe the plan of care individualized to findings, life-span stage of development with culturally specific considerations for each focused area of assessment.
In regards to APA format, please use the following as a guide:
18 16 0
Points Earned
Focus of the Assessment is identified with Special Considerations including:
Documented Focused Health History
Individualized Plan of Care Based Upon Clinical Findings
Developmentally and Culturally Specific
Demonstration of Compliance with Ethical and Legal Standards of Professional Nursing Practice
Grammar, Spelling, and Punctuation APA Format
COMMENTS:
TOTAL: /100
Your Results
Reopen (/assignment_attempts/6077725/reopen
Lab Pass (/assignment attempts/6077725/lab_pass.p
Overview Transcript
Objective Data Collection: 21 of 21 (100%)
Subjective Data Collection
Objective Data Collection
Education & Empathy Documentation
Care Plan
Skull Symmetry (1/3 point)
Facial Feature Symmetry (1/3 point)
Appearance (1/3 point)
Inspected nasal mucosa 1 of 1 point
Inspected mouth 1 of 1 point
Oral Mucosa (1/1 point)
Inspected abdomen 1 of 1 point
Symmetry (1/3 point)
Contour (1/3 point)
Appearance (1/3 point)
https://www.coursehero.com/file/54630935B/Euslgthinegr-aPraoruknsd-Aubmdboilmicuinsal-Pain-ObjectiveData-Shadow-Healthpdf/
Inspected for edema in lower extremities 1 of 1 point
Right: Edema (1/4 point)
Right: Severity Of Edema (1/4 point)
Left: Edema (1/4 point)
Left: Severity Of Edema (1/4 point)
Auscultated heart sounds 1 of 1 point
Heart Sounds (1/2 point)
Extra Heart Sounds (1/2 point)
Auscultated breath sounds 1 of 1 point
Breath Sounds (1/3 point)
Adventitious Sounds (1/3 point)
Location (1/3 point)
Auscultated abdominal aorta 1 of 1 point
https://www.coursehero.com/file/54630935/Esther-Parks-Abdominal-Pain-ObjectiveData-Shadow-Healthpdf/
Sound (1/1 point)
Auscultated bowel sounds 1 of 1 point
Bowel Sounds (1/2 point)
Location Of Non Normoactive Bowel Sounds (1/2 point)
Auscultated abdominal arteries 1 of 1 point
Right: Renal (1/6 point)
Right: Iliac (1/6 point)
Right: Femoral (1/6 point)
Left: Renal (1/6 point)
Left: Iliac (1/6 point)
Left: Femoral (1/6 point)
Percussed abdomen 1 of 1 point
Observations (1/1 point)
Percussed CVA tenderness 1 of 1 point
Patient Reaction (1/1 point)
Percussed spleen 1 of 1 point
Spleen (1/1 point)
Percussed liver 1 of 1 point
Liver Span (1/1 point)
Palpated abdomen – light 1 of 1 point
Tenderness (1/3 point) Location Of Tenderness (1/3 point)
https://www.coursehero.com/file/54630935N/Eosnteherer-pPoarrtekds-Abdominal-Pain-ObjectiveData-Shadow-Healthpdf/
Observations (1/3 point)
Guarding Distension
Palpated abdomen – deep 1 of 1 point
Presence Of Unexpected Mass (1/2 point)
Location Of Mass (1/2 point)
Palpated liver 1 of 1 point
Detection (1/1 point)
Palpated spleen 1 of 1 point
Detection (1/1 point)
Palpated bladder 1 of 1 point
Detection (1/1 point)
Palpated kidneys 1 of 1 point
Right (1/2 point)
Left (1/2 point)
Tested skin turgor 1 of 1 point
Observations (1/1 point)
Assignment 12: SOAP Note and Patient Case
Psychiatric notes are a way to reflect on your practicum experiences and connect them to the didactic learning you gain from your NRNP courses. Focused SOAP notes, such as the ones required in this practicum course, are often used in clinical settings to document patient care.
For this Assignment, you will document information about a patient that you examined during the last three weeks, using the Focused SOAP Note Template provided. You will then use this note to develop and record a case presentation for this patient.
Please Note:
When you submit your note, you should include the complete focused SOAP note as a Word document and PDF/images of each page that is initialed and signed by your Preceptor.
You must submit your SOAP note using SafeAssign. Note: If both files are not received by the due date, faculty will deduct points per the Walden Grading Policy.
Then, based on your SOAP note of this patient, develop a video case study presentation. Take time to practice your presentation before you record.
Include at least five scholarly resources to support your assessment, diagnosis, and treatment planning.
Ensure that you have the appropriate lighting and equipment to record the presentation.
Record yourself presenting the complex case study for your clinical patient. In your presentation:
Be succinct in your presentation, and do not exceed 8 minutes. Specifically address the following for the patient, using your SOAP note as a guide:
Subjective:
What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
Objective:
What observations did you make during the psychiatric assessment?
Assessment:
Discuss their mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses and why you chose them. List them from highest priority to lowest priority. What was your primary diagnosis and why? Describe how your primary diagnosis aligns with DSM-5 diagnostic criteria and supported by the patient’s symptoms.
Plan:
What was your plan for psychotherapy? What was your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan.
Also be sure to include at least one health promotion activity and one patient education strategy.
Reflection notes:
What would you do differently with this patient if you could conduct the session again? If you are able to follow up with your patient, explain whether these interventions were successful and why or why not. If you were not able to conduct a follow up, discuss what your next intervention would be.
HPI: Patient reports ongoing struggles with depression and anxiety, recently exacerbated by new job challenges and body image concerns. Initiated therapy and is exploring medication optimization, including genetic testing.
Past Psychiatric History:
Substance Current Use and History: Denies drug and alcohol abuse, except for social drinking.
Family Psychiatric/Substance Use History: Father with DM, HTN, hypothyroid; mother with HTN; sister on Lexapro with weight gain.
Psychosocial History: Lives alone. Enjoys activities like working out, gym, yoga, and beach visits. Denies tobacco use, no history of STDs.
Assessment Mental Status Examination: Kempt appearance, alert, cooperative behavior, limited focus, intact memory, low mood, adequate sleep, calm gross motor activity, normal gait, no tremors, oriented, appropriate eye contact, normal rate of speech, congruent affect, logical thought process, no delusions, fair insight and judgment.
Reflecting on the learning experiences of this quarter, the comprehensive case study of a patient with complex psychiatric needs stands out as a pivotal element of my educational journey. This case has served as a practical application of theoretical knowledge, bridging the gap between textbook learning and real-world clinical scenarios. It emphasized the importance of a thorough understanding of various psychiatric conditions, including Major Depressive Disorder, Generalized Anxiety Disorder, and Attention Deficit Hyperactivity Disorder, among others.
The patient’s case was particularly enlightening in understanding the intricacies of psychiatric comorbidities. Dealing with multiple diagnoses within a single patient highlighted the necessity of a holistic approach in mental health care, where different disorders often interplay and impact one another. This aspect of the learning has deepened my appreciation for comprehensive patient assessments, considering not just the presenting symptoms but also the broader psychosocial context.
One of the most significant learnings from this quarter has been the importance of detailed patient history in forming an accurate diagnosis and effective treatment plan. The patient’s past experiences, responses to various medications, and personal lifestyle choices all played a crucial role in shaping her current mental health status. This reinforced the value of patient-centered care, where understanding and integrating the patient’s preferences, concerns, and unique life circumstances are as crucial as clinical expertise.
Additionally, this quarter has brought into focus the importance of psychotherapy in treating mental health conditions. The patient’s proactive approach to finding a suitable therapist and her engagement in therapy sessions underscored the role of psychotherapeutic interventions in conjunction with pharmacotherapy. The case also served as a reminder of the impact of life transitions and stressors on mental health. The patient’s challenges with body image and recent job change were stark examples of how external factors can exacerbate existing mental health conditions, emphasizing the need for adaptive and responsive treatment plans.
Moreover, working through the process of developing differential diagnoses for this patient was a rigorous exercise in critical thinking and clinical reasoning. It required a careful analysis of the patient’s symptoms, a deep understanding of how various conditions manifest, and an ability to discern the subtleties of different psychiatric disorders. Lastly, this experience highlighted the significance of multidisciplinary collaboration in mental health care. The patient’s situation, involving a primary care provider for her polycystic ovary syndrome and the potential coordination with genetic testing specialists, illustrated the interconnectedness of various health care domains in managing complex cases.
Carlini, S. V., & Deligiannidis, K. M. (2020). Evidence-based treatment of premenstrual dysphoric disorder: A concise review. The Journal Of Clinical Psychiatry, 81(2), 6789. https://www.psychiatrist.com/jcp/evidence-based-treatment-of-pmdd/
Cortese, S. (2020). Pharmacologic treatment of attention deficit–hyperactivity disorder. New England Journal of Medicine, 383(11), 1050–1056. https://www.nejm.org/doi/full/10.1056/NEJMra1917069
Marx, W., Penninx, B. W., Solmi, M., Furukawa, T. A., Firth, J., Carvalho, A. F., & Berk, M. (2023). Major depressive disorder. Nature Reviews Disease Primers, 9(1), 44. https://doi.org/10.1038/s41572-023-00454-1
Nilsson, J., Sigström, R., Östling, S., Waern, M., & Skoog, I. (2019). Changes in the expression of worries, anxiety, and generalized anxiety disorder with increasing age: A population study of 70 to 85?year?olds. International Journal of Geriatric Psychiatry, 34(2), 249-257. https://doi.org/10.1002/gps.5012
Stein, D. J., Costa, D. L., Lochner, C., Miguel, E. C., Reddy, Y. J., Shavitt, R. G., & Simpson, H. B. (2019). Obsessive–compulsive disorder. Nature reviews Disease primers, 5(1), 52. https://doi.org/10.1038/s41572-019-0102-3
Also Read: NURS 6003 Academic Success And Professional Development Plan Part 1
Find an operations-based company you are familiar with and research its use of suppliers. First, look at what companies have already reported on and try not to duplicate what someone else has analyzed.
Finally, see if you can identify the company’s primary risks with its source. The response must be 250 + words.
Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.
Communication is so very important. There are multiple ways to communicate with me:
Assignment 6: Origin of emotional and psychological issues.
S02 Introduction to Psychology II
Objectives:(1) Identify anxiety disorders.
(2) Describe the origin of emotional and psychological issues.
Part A
Susan, a college student, is anxious whenever she must speak. Her anxiety motivates her to prepare meticulously and rehearse material again and again. Is Susan’s reaction normal, or does she have an anxiety disorder? Explain two (2) criteria you used in arriving at your answer.
Part B
In recent years, several best-selling books have argued that most emotional problems can be traced to an unhappy or traumatic childhood (an abusive or dysfunctional family, “toxic” parents, and suppression of the “inner child”). What are two (2) possible benefits of focusing on childhood as the time when emotional problems originate, and what are two (2) possible drawbacks
Part C
Suppose a member of your family has become increasingly depressed in recent months, and it’s apparent that the person needs treatment. You’re chosen to look into the options and to make decisions about the treatment. Based on information in Chapter 16, how might you proceed? Provide two (2) supporting facts to justify your plan of action.
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.
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Health care policy Assignment 6
Emergency Response Planning Assignment 6
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NUR 513 Week 6 Quiz Assignment
Assignment 9: Foreign health care system
Choose a country other than the United States and research its health care system.
Provide an overview of your selected country’s health care system and ANSWER all the questions below:
Describe any foreign health care system by answering the following questions:
Identify at least two examples of similarities between your selected country and theS. health care system.
Differentiate between S. health care and your chosen country’s health care system by sharing at least two differences.
You must use a government resources from your chosen country and the textbook ONLY Batnitzky, A., Hayes, D., & Vinall, P. E. (2018). The U.S. healthcare system: An introduction. Retrieved from https://content.ashford.edu
ONLY your research and response. Wikipedia is not an acceptable source for any discussion or assignment. You may also want to review What Is CRAAP? A Guide to Evaluating Web Sources.
DUE 2/1/19 @8AM EASTERN STANDARD TIME ZONE
ATTACH TURNITIN REPORT WITH ANSWER
Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.
Communication is so very important. There are multiple ways to communicate with me: